Understanding DBT Modules: Mindfulness

Dialectical Behavior Therapy (DBT) is quickly becoming one of the most popular forms of therapy used by mental health professionals. This form of psychotherapy assists with treating a wide range of mental health disorders; although it was initially developed to treat borderline personality disorder, it has since been adapted to treat other mental health issues such as suicidal behavior, substance abuse, post-traumatic stress disorder (PTSD), depression, eating disorders, and even traumatic brain injuries.

DBT is comprised of four modules: mindfulness, distress tolerance, emotional regulation, and interpersonal effectiveness. Each module focuses on select skills that help alter an individual’s behavior to improve their quality of life and ensure better personal relationships.

The first and one of the most important modules is mindfulness.

What is mindfulness?

Mindfulness is one of the core ideas behind DBT. Many consider it a foundational skill. The concept in DBT is from traditional Buddhist practices. Patients are taught to pay attention to the present moment in a non-judgmental fashion. It also teaches people how to live in the moment, and experience one’s emotions and senses fully with perspective. This DBT module also relies on the concept of acceptance.

How does mindfulness help with DBT?

Mindfulness in DBT relies heavily on acceptance. During DBT sessions, once the patient becomes comfortable with therapy, they learn the idea of acceptance and change. Patients learn “radical acceptance”, where one embraces the idea that they should face situations, both good and bad, without judgment.

Once patients become comfortable with acceptance, they learn about change. There are five states of change: pre-contemplation, contemplation, preparation, action, and maintenance.

What sets DBT apart from other therapies is that mindfulness incorporates emotional regulation skills as well. Using emotional regulation, patients involved in DBT therapy learn to sense and accept situations, and then how to cope with and change these situations.

Are there any mindfulness skills in DBT?

DBT teaches patients tons of useful skills, which they practice in therapy before adopting into their regular life. For mindfulness, patients learn “what” and “how” skills.

“What” skills include:

Observe: Non-judgmental observation of one’s environment within and outside
Describe: Express what one has observed
Participate: Fully focus on the activity one is doing

“How” skills include:

Non-judgmental thinking of actions with facts, not in terms of “good”, “bad”, “fair”, or “unfair”
One-mindfully: Focus on one thing to keep the mind from straying into emotions
Effectively doing what works

How long does DBT focus on this module?

Mindfulness is a key component of DBT. Each module is broken up into sections. Each module takes about 6 weeks time, however, mindfulness helps to break up each of the other modules. For example, a DBT patient will spend two weeks on mindfulness, move onto distress tolerance, spend another two weeks on mindfulness, and then continue to the next module.